MCAT: Learning to Overcome Fear

Overcoming the MCAT = Overcoming Yourself 

Perhaps one of the greatest learning experiences of my life was overcoming the MCAT. When I say overcoming, I don't mean passing or scoring the magic score you need to attend dream school X. I mean overcoming, as in learning to overcome the fear and self-doubt, the anxiety and intensity that results from an exam that seems like it has the power to change your destiny. Here are the lessons no Kaplan, Princeton, or Berkeley Review could have ever taught me. 

1. The Biggest Enemy is Yourself 

 The first time I took the MCAT I choked. I remember sitting there looking at the first problem of physical science. Gravitation. I knew about gravitation, I even knew the formulas, but I hadn't specifically worked on a problem like this in my review. So I sat there for fifteen minutes trying to work through problem number one. The thoughts ran threw my head: 

 "You're going to fail....You won't be a doctor...This is the biggest exam of your life...You've wasted too much time...Everything you've done up to this point won't matter if you do poorly on this exam"

By the time I snapped out of it, fear and anxiety had won. I hit the void button and left heartbroken. In retrospect, this lesson was exactly what I needed to grow. The next time I prepared for the MCAT, I knew that a good score wasn't so much dependent on intellect as it was on mental stability and positivity. What did I do differently next time? Several things... 

         A. Positive affirmations work - tell yourself you are proud, during your breaks build up your spirit as if you are talking to a team and want to win the game

B. Find and use a support group (they may have a better perspective on YOU than you do). 

C. Practice deep breathing and meditation. While this may sound corny, deep breathing has been shown to reduce stress and anxiety levels during tests 

2. You Must Believe You Can Do It 

The median separating arrogance and self-abasement is confidence. Finding this median is the key to doing better on the MCAT. I'm not talking about manipulating yourself into some form of pseudo-confidence. I'm talking about believing you have what it takes to past the MCAT because it is the truth. Seriously, building up the confidence makes the daunting MCAT much more easily surmountable. 

3. Nothing Is Worth Your Health and Well-Being

The second time taking the MCAT was much different. For two months, I studied 8 hours a day (albeit quite unhealthy). In order to accomplish this task I stopped hanging out with friends, I stopped going to the gym, and I started to neglect my health and well-being. I thought I had a good excuse. I mean after all, passing the MCAT takes time and effort. I believed that the more intellectual effort I put in, the higher score I would receive. This was completely false. I learned that just as important as scholastic endeavors, I needed to keep myself healthy. The week before the exam I realized this critical mistake and started to take care of my mental and physical health. Why isn't your health and well-being worth being sacrificed? Well, because of #4. 

4. There Will Always Be Another Hurtle

My mind often makes things seem so black and white. I get into medical school or I get rejected from medical school. I score an acceptable score on the MCAT or I bomb the MCAT. This isn't reality. Reality has hints of grey. I use to tell myself, "once I get _____ I'll be happy". Happiness, I've learned, doesn't work like this. I have to learn how to be happy now, in the moment because there will always be something to stress over. 

I left the MCAT room for the second time a couple of months ago. I managed not to hit the void button again, but I came out feeling like I failed everything. And I mean everything. Good news though! I managed to pass the MCAT, but more importantly, I learned how to overcome my fears. 


By: Brian Covello

A Doctor Explains Why Everyone On 'Game of Thrones' Should Be Dead

A trauma expert gives us the scoop on whether you could survive beheadings, disfigurements and wang removals.

by Kat Rosenfield

When you play the Game of Thrones, you win or you die — or, sometimes, you sustain life-altering horrible injuries that are agony to endure and disgusting to behold!

As anyone who’s ever spent a Sunday night glued to HBO’s “Game of Thrones” knows, living in Westeros is a risky business. At any moment, you might take a sword to the face, or a screw to the foot, or have your Hodor hodored off by some crazy hodoring bastard.

And yet, strangely enough, most of the show’s grievously injured characters are still alive, in some cases seemingly against all odds. But in real life, could they really survive?

We brought in Dr. Deborah Mogelof, a physican with special expertise in trauma, to give us the rundown on “Game of Thrones’” most exciting medical mysteries.

The Face Wounds of Tyrion Lannister
Thanks to a traitorous swordsman, Tyrion’s face isn’t quite as pretty as it used to be — albeit in better shape than in the source material. In “A Clash of Kings,” he loses his entire nose in the Battle of the Blackwater. Our medical source, consulting footage of the petite Lannister’s injuries, had this to say.

Dr. Mogelof: Even if the nose were cut off completely, there are no major vessels right there. I’ve also seen people get their noses shot off and recover.

MTV: So despite getting slashed, it’s reasonable for him to still be alive?

Dr. Mogelof: Well, looking at his wound, you can see that golden-yellow kind of crusting to it. It does look like impetigo, which is a staph or strep infection. So it would already be infected there, although I don’t know if they meant for it to look like that. But provided that it’s cleaned out immediately, this is a survivable injury.

CONCLUSION: Assuming that Tyrion’s crusty face was the mistake of an overzealous makeup artist, our favorite Lion of Lannister would still be alive and kicking, even if he weren’t living in a Westerosian fantasy world.

Get All Caught Up On Who’s Who In Westeros With Our Interactive Map

Jaime Lannister’s Lost Hand
After being ignominiously relieved of his hand by one of Roose Bolton’s men, Jaime nevertheless managed to make a full (albeit stumpy) recovery. But according to Dr. Mogelof, a real-life amputation wouldn’t be so easy to contend with.

Dr. Mogelof: The biggest thing you would worry about is infection, which would happen quickly, in a matter of hours, especially if he’s walking around in the forest. It would spread to his lymph glands, then throughout his body. And the loss of a hand, that’s a big problem, too, obviously. But sepsis and dying of sepsis would be the primary risks.

MTV: He does encounter a sort of healer (Maester Qyburn) who cuts away the gangrenous tissue from his stump. Would that make any difference?

Dr. Mogelof: Getting rid of the dead, septic tissue is helpful, but I don’t think it would 100% treat him without antibiotics. Doing only the surgical part would probably prolong his survival, but not cure him.

MTV: On a completely different note, Jaime Lannister is also involved in an incestuous sexual relationship with his twin sister. Any medical risks associated with that?

Dr. Mogelof: Not with the sexual relationship specifically. Although at that time [the 1400s, the historical era which "Game of Thrones" most closely resembles], one thing that was rampant was sexually transmitted disease. And of course, if she gets pregnant, there would be a lot issues with that baby.

MTV: Like, he might grow up to be a power-hungry little sadist? Because that would explain a lot.

Dr. Mogelof: …No.

CONCLUSION: In real life, Jaime Lannister would probably be dead of septic shock, and possibly riddled with STDs given to him by Cersei. We cannot, however, blame him for Joffrey Baratheon.

Watch Peter Dinklage Sum Up ‘Game Of Thrones’ In 45 Seconds

The Decapitation of Ned Stark
No, you can’t survive a beheading. Yes, we asked. But if you were curious about it:

Dr. Mogelof: There are people who claim that they’ve seen beheaded bodies with reflexes after, where the head still makes facial expressions. The research supports that: you might get some blinking or twitching. But your spinal cord is completely severed, there’s a lot of blood loss, there’s no oxygen going to your brain. It would just be a reflex, the last bit of neurons firing off and that’s it.

MTV: So, just to ask the ridiculous question: how beheaded could you be, and still survive?

Dr. Mogelof: You would have to miss the spinal cord. If there’s any destruction of the first and second vertebrae, you’re not going to be able to breathe. But if you miss the major vessels, and someone gets you somewhere where you can be sewn up and fixed immediately, you might survive.

CONCLUSION: Sorry, kids, but Ned Stark is really, truly dead.

The Theon Greyjoy Catalog of Pain
It’s the one you’ve all been waiting for: Theon Greyjoy! Beaten, tortured, flayed, impaled, and cruelly relieved of his fingernails and his wiener, the poor captive of Bolton bastard Ramsay Snow made for a lengthy medical discussion.

MTV: Let’s start with the least of Theon’s woes: he’s strapped to a rack and deprived of food and water.

Dr. Mogelof: Right. In that case, your worry is pure dehydration. Your kidneys start to shut down, you get an electrolyte imbalance. Your potassium can go up or down, which can eventually cause cardiac arrest.

MTV: And assuming you survive that long, then there’s the fingernail pulling, the screw through the foot, the flaying. Plus, they’ve broken his teeth.

Dr. Mogelof: Most of this hurts a lot, but it’s not going to kill you. You have to worry about infection; you have to worry about the screw going through the bone, or with the teeth, if there are roots or nerves exposed.

MTV: And this is all just a prelude to the big one: penis amputation.

Dr. Mogelof: Although that’s very painful, it’s survivable. There are no major vessels in there.

MTV: What would be the challenges of living with an injury like that? I’m especially curious about how he’d pee.

Dr. Mogelof: Well, in today’s world — like when Lorena Bobbitt did it — they do a reconstruction. You’d have a kind of fake penis going on there. But in this case, there would still be some part of the urethra hanging out, and it could dribble out of there. As long as he continues to use it, it’ll remain open.

Really, it’s probably most difficult to recover from this psychologically. The big problem for guys is that their sexual impulse isn’t from the penis, so [if the penis is amputated], they’re still having that impulse, but they can’t do anything about it. I think it’s extremely frustrating.

MTV: So what you’re saying is, at this point, it would actually be better for Theon if they went back and cut off the rest of his… equipment?

Dr. Mogelof: Basically, yes. I think that would alleviate the need to, ah, do something about it.

CONCLUSION: In real life, Theon Greyjoy would most likely be just as miserably, horrible, sexually frustratedly alive as he is in his fictional universe — and probably praying for a nice, fatal potassium imbalance to put him out of his misery.

“Game of Thrones” returns to HBO on Sunday, April 6 at 9 p.m. ET, ready to release a whole new set of injuries on all of your favorite characters.

Brian Covello

The AMCAS Personal Statement: Why MD?

Brian Covello: Writings of PreMD Post #2

5 Tips and Tricks to Help You Write Your Personal Statement

It's funny how five simple letters, Why MD, can cause premeds such despair. For people applying to MD programs, the AAMC has a common application service called AMCAS. Amongst other things, AMCAS has a section to answer this crucial question. MCAT, GPA, and extracurriculars aside, this is one of the rare opportunities aspiring medical students have to tell an admissions committee who they are. The exact prompt is:

"Use the space provided to explain why you want to go to medical school. The available space for your response is 5300 characters, or approximately one full page."

Yes, you have 5300 characters to describe and detail your entire motivation for becoming an MD. At first, a full page of writing seems insignificant to the coursework required to pursue medicine, but being able to express your motivation in an appropriate manner is harder than it looks. Thankfully, resources abound on the internet, and schools such as Johns Hopkins has some particularly great advice for how to approach this essay. For more links head to the end of this post. 

The biggest lesson I've learned about personal statements are that they have to be personal. Each of us has a story and a lifetime of experiences. Use your personal experiences to show the admissions committee your motivation. I cannot stress this enough. Show don't tell. Instead of writing, "I am compassionate," gives examples of situations you believe best shows your compassion. 

Here are some tips and tricks that really helped me along the way: 

1) Make a list of all your volunteering and clinical experiences. I'm not talking about that time you worked as a scribe. Instead, write down those moments with patients and doctors that affected you. Maybe as a scribe you saw a patient pass away. What affect did that have on you? Has your heart ever ached when you have seen someone in pain? How did you react? Don't just list the event. Go into detail. Explore your feelings. It is this type of introspection that will help you craft a heartfelt essay. 

2) Free Write. Let's be honest. As premeds we are heavily science based, and writing isn't always our forte. I'll be the first to admit that more college courses in writing would've benefited me in this process. The answer for me is to free write. Write whatever comes to your mind when you are in the midst of introspection. Don't worry about grammar or fancy words. Just write. 

3) Give yourself ample time. I started the first drafts of my personal statement nearly one year before I applied. Giving yourself time allows your essay to soak in and gain new life. With introspective writing especially, time away from the work allows us to view it with a fresh mind. Countless times I have written something that I believed to be of quality, only to come back a month later and realize it's garbage. 

4) Instantly grab your reader's attention. Imagine it's a Friday night. You have just come home from a stressful and long day at work. Time to relax? Not yet. You've been assigned 100 personal statements to read, and they must be read by Monday. So you sit down and begin to read. Stop for moment. Imagine what it would be like reading 100 essays with the exact same topic. This is exactly the task admissions committee members are faced with. You must grab your readers attention. Make it fun for them to read. When you are done writing, take some time away from your essay. With a fresh mind read your first paragraph only. Ask yourself, if this were someone else's essay would you want to keep reading? Would you be entertained? Would this essay cause an emotional response? 

5) You are not unique, but you are unique. Being an applicant who brings something to the table that admissions committee's haven't seen is nearly impossible. They've seen it all, from the person who worked at NASA to the army veteran who earned a purple heart. This, combined with the fact that applicants must fulfill roughly the same general requirements (clinical work/volunteering, non-clinical volunteering, research, etc) means none of us are unique. Contrary to popular belief, your personal statement doesn't have to "stand out" from the thousands of other applicants. What should stand out though is your own personal experience. You might not be the only applicant to have volunteered in a homeless clinic, but maybe you are the only applicant who formed a close bond with Linda and helped teach one of her children how to read. Bottom line: You might not be original, but you do have experiences no other applicant does. 

So what does all this mean to the premed who has yet to start the application process? It means you must acquire the experience necessary for all this messy introspection. More than anything, your personal statement is a reflection of who you are. The more exposure you have, the more you have to write about. 

When I was writing my personal statement, I made an effort not to look at other personal statements because I didn't want to subconsciously imbibe their style. If you've already written your personal statement, or if you think having an example will help you, I have placed an essay from a Stanford Medical Student Below: 

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A tampon and a condom. According to backpacking folklore those two little items comprise the most basic first aid kit capable of managing injuries encountered in the wilderness; a tampon to stint blood flow and a condom to act as an elastic bandage and protect wounds from bacteria. For most of my twenty-one years I assumed the closest I would ever come to practicing medicine would be makeshift bandages and the occasional CPR class. Now I think back on a day six years ago when I fought a losing battle with the anesthesiologist. In the time it took me to drool all over myself a surgeon skillfully removed the tattered remains of my ACL and screwed a piece of tendon into its place. Hours later I stared with fascination at the video of the reconstructive surgery filmed from within my knee. Unbeknownst to me at the time, what had initially seemed a cruel blow of fate had in fact guided me onto the path that was to become my life's passion: medicine.

I am often amazed at the remarkable ability with which living systems adapt to extreme environmental variation. After listening to a friend recount his nude run around the South Pole and back into his research station's sauna, an incredible 350 degree temperature swing, it would seem the human body is robust enough to withstand any force of nature. Yet, as I know all too well from my research on Alzheimer's disease, even something as miniscule as a single point mutation can have profound and deadly consequences. Continuously designing and analyzing my own experiments has not only taught me the value of diligence, patience and replication in the laboratory setting, but it has also instilled in me a profound respect for the biological intricacies that make life possible. In my mind the rewards of medicinal research stem from its practical application. A physician acts as a conduit between the test tube and the bedside, thus they are able to experience both the joy of investigating the unknown as well as developing the gratifying doctor-patient relationships unique to medicine. As a physician the critical-thinking and problem-solving skills I have honed through research will enable me to tackle difficult, and sometimes unknown, problems with sound reasoning and confidence.

When the doctor gravely told me I had torn my ACL he was met with a blank look. Realizing my confusion he pulled out a model of the human knee and proceeded to explain my condition in a way I could see and understand. My experience highlights one of the most critical skills a physician must master, the ability to communicate. As a math and science tutor at my university I have discovered I have the ability to explain difficult concepts to people whom are seeking help and clarification. I must not only find the answers to student questions, but also determine the best way to convey the information in terms they can comprehend. In the future my communication skills will enable me to effectively explain a patient's condition so that they understand what is happening to their body and are not left feeling bewildered or out of control. This bedside manner will help me gain the patient trust and intimacy that is so crucial to medicine and the recovery process.

The interpersonal relationships in medicine appeal to my deep appreciation for human life and my desire to serve society in a beneficial way. As a physician I will be able to make a direct and immediate impact on my patient's wellbeing; whether in the form of a complicated medical procedure or simply a hand to hold during the final hour. Already, through my volunteer work at St. Joseph's Hospital, I have come to appreciate the unequivocal importance of human compassion. My most rewarding responsibility is delivering flowers to patients in the ICU. When presented with a cheery bouquet of fresh flowers their eyes light up and the severity of their situation is forgotten, if even for only a moment. Sometimes empathy is the best medicine and I will never underestimate the healing qualities of a smile and a flower.

Fortunately not all aliments warrant a trip to the ICU and many once-incurable conditions can now be overcome with the aid of a practiced physician. For nine long months after my surgery I battled my way through rehabilitation, sometimes wondering if I would ever play competitive sports again. But my doctors and therapists patiently facilitated my recovery; such was their skill that when I competed at the National Track and Field Championships last spring the only observable evidence of my injury was a few small dots of scar tissue. The road to recovery is not easy, but having been through the process myself I will be better prepared to connect with my patients and guide them through their experience.

I smile at the irony of my situation, it took a personal injury for me to realize I wanted to spend my life working to alleviate the pain of others. The sheer pleasure I derive from helping people and sharing what I know, coupled with the mental stimulation intrinsic to the profession, make medicine the clear career pathway for me. Hopefully, if someday my first aid kit falls into the river and I am forced to resort to condoms and tampons, I will wield those tools with the expertise and confidence of a practiced medical doctor.

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Well that about sums it up. Good luck to everyone! You can find some helpful links below. 

Student Doctor Network Advice

Thoughts from Yale

Harvard's Open Courseware

Brian Covello

The First Writing of a PreMD

Brian Covello: Writings of a PreMD Post #1

The First Writing of a PreMD

My name is Brian Covello, and for the past four years I have been an MD-hopeful. I have just recently graduated from a small liberal arts college, where I pursued majors in Biochemistry and Math. My dream of becoming a doctor has been with me from a very young age, but it has taken many experiences for me to truly know that this is the path for me. 

Hopefully this blog will help me share what I have learned along the way and record what is to come as I walk through the long and tedious process of medical school admissions. By and large, medical school admissions can feel like a number game, but I'd to talk about more than "stats" by diving into the personal qualities that often escape the pen and ink of a resume. This blog will be dedicated towards that end. So here it is. My first blog post. Short & Sweet. Thank you for reading, and hopefully you'll follow me on this journey. 

If you'd like to know about me, please visit: 
www.facebook.com/brian.covello
www.pinterest.com/briancovello

Brian Covello